The neonatal period represents the most vulnerable time for a child’s survival. In 2016, roughly 46% of all under-five deaths occurred during this period (WHO). According to the most recent global estimates, preterm births, infections and congenital anomalies are currently the leading causes of death in children under 5 years (Liu, Lancet 2016). Additionally, the implications of being born too soon, to have a congenital anomaly, to acquire an infection or another complication early in life often extend beyond the neonatal period and throughout the whole life cycle. These babies face greater risks of serious health problems (cerebral palsy, intellectual impairment, chronic lung disease, and vision and hearing loss) (WHO, Born too soon, 2012). The psychosocial, emotional and economical impact of these conditions for the families, the heath system and the whole society is tremendous. If, from one side, parents of babies in NICUs or semi-intensive care units suffer a high degree of psychophysical distress (Al Maghaireh 2016, Provenzi 2015), on the other hand, they have a crucial role in supporting the health and neurological (including emotional) development of their babies, both during hospitalization and after discharge. Indeed, evidence show that middle and long-term developmental outcomes (ie, after 36 months of age) of these babies are closely related to aspects of the early social environment, such as parents’ ability to provide an environment conducive to resilience (WHO, Born too soon, 2012). Consequently, effective interventions for strengthening the copying strategies of the parents, increasing their nurturance capacity, their knowledge and skill on how to take care for the baby and mutual collaboration with hospital staff, are desperately needed. Overall, the existing literature suggest that interventions for empowering families of pre-term babies (such as NIDCAP, COPE) may have major impact on the health and wellbeing of pre-term babies, their parents, and on the health system. Studies have showed that interventions for empowering families of pre-term babies improve newborn health outcomes (such as weight at discharge, hospitalization and length of stay), decrease parental negative symptoms (such as anxiety, stress and depression), improve parent-infant and parent-health worker interaction during hospital, improve parental satisfaction and reduce costs for the health systems (Melnyk 2006, Melnyk 2009, Brett 2011, Beheshtipour 2014, Dol 2017). However, still there is limited experience in this field, and the practice of providing practical support to families of pre-term babies - in terms of a specific, individualized, comprehensive, family-integrated model of care is not wide-spread among facilities, even in high income countries, such as Italy. In low resources settings, where the burden of premature children is higher, and their outcomes are worst, almost no experience exists in this field.
EPINICU (Empowering Parents of newborns in the NICU) was born form these premises. It is an ongoing multicenter multicountry before and after intervention study involving 4 countries (Italy, Tanzania, Brazil and Sri Lanka) and different partners (CUAMM, IMIP, WHO Head Quarters Geneva), approved by the Institutional Review Board of Friuli Venezia Giulia Region (Prot.31633, October 22, 2019) and by all Ethical Committees of partners’ institutions.
Aim of EPINICU is to assess parental mental health and participation in care in the different settings, and develop and test low-cost setting-specific interventions to empower parents in the NICU.
The key objective of my PhD was the coordination of the project at the Italian site while collaborating with the multicountry project.
1) Bua J, Prescott E, Schack-Nielsen L, Petersen L, Godtfredsen NS, Sorensen TIA. The effect of weight history from birth through childhood and youth on adult lung function, in Danish obese and non-obese men. (abstract) Eur Resp J 2004; 24: 433s.
2) Bua J, Marchetti F, Barbi E, Sarti A, Ventura A. Tremors and chorea induced by cotrimoxazole in a child with pneumocystis pneumonia. Pediatr Infect Dis J. 2005; 24: 934-5.
3) Bua J, Prescott E, Schack-Nielsen L, Petersen L, Godtfredsen NS, Sorensen TIA. Weight history from birth through childhood and youth in relation to adult lung function, in Danish juvenile obese and non-obese men. Int J Obes 2005; 29: 1055-62.
4) Marchetti F, Bua J. More evidence is needed in the antibiotic treatment of Pseudomonas aeruginosa colonisation. (letter) Arch Dis Child. 2005; 90: 1204
5) Rugholm S, Baker J, Olsen LW, Schack-Nielsen L, Bua J, Sorensen TIA. Stability of the association between birth weight and weight and childhood overweight during the development of the obesity epidemic. Obesity Research 2005; 13: 2187-94
6) Marchetti F, Bua J, Ventura A. Pneumococcal vaccination for acute otitis media. (letter) Lancet. 2006; 367: 1897.
7) Marchetti F, Ronfani L, Bua J. et al. Effect of TOBI on the eradication of Pseudomonas colonisation in cystic fibrosis. (abstract) J Cystic Fibrosis 2006; 5: s22.
8) Bua J, Marchetti F. Analgesia and appendicitis: no longer a dilemma. (e-letter) BMJ 2006; 333. Rapid response to: Humes DJ, Simpson J. Acute appendicitis BMJ 2006; 333; 530-34.
9) Marchetti F, Bua J, Lazzerini M. Oral or inhaled coricosteroids for the treatment of croup? (letter) Arch Dis Child Educ Pract Ed. 2007;92: ep13
10) Bua J, Olsen L, Sorensen TIA. Secular trends in childhood overweight and obesity in Denmark during 50 years in relation to economic growth. Obesity (Silver Spring). 2007; 15: 977-85.
11) Marchetti F, Bua J, Ventura A, Notarangelo LD, Di MaioS, Migliore G, Bonati M. The awareness among paediatricians of off-label prescribing in children: a survey in Italian hospitals. Eur J Clin Pharmacology 2007; 63: 81-5.
12) Radzik D, Bua J, Marchetti F. Opiates and acute abdominal pain.(letter) JAMA. 2007 Feb 7;297: 467-8
13) Verzegnassi F, Bua J, De Angelis P et al. Eosinophilic oesophagitis and coeliac disease: is it just a casual association? Gut. 2007;56: 1029-30.
14) Marchetti F, Bua J, Ventura A. Drugs for the treatment of gastro-oesophageal reflux: in search of clear evidence-based indications.(letter) Arch Dis Child. 2007; 92 : 1143
15) Tornese G, Bua J, Marchetti F. More on tuberculosis. (letter) Lancet. 2008: 23; 371: 647
16) Bua J, Lepore L, Martelossi S, Ventura A. Video capsule endoscopy and intestinal involvement in systemic vasculitis. Dig Liver Dis. 2008;40: 905.
17) Bua J, L'Erario I, Barbi E, Marchetti F. When off-label is a good practice: the example of paracetamol and salbutamol. Arch Dis Child. 2008; 93: 546-7
18) Cattaneo A, Timmer A, Bomestar T, Bua J, Kumar S, Tamburlini G. Child nutrition in countries of the Commonwealth of Independent States: time to redirect strategies? Public Health Nutr. 2008;11: 1209-19.
19) Galli L, Puliti D, Chiappini E, Gabiano C, Ferraris G, Mignone F, Viganò A, Giaquinto C, Genovese O, Anzidei G, Badolato R, Buffolano W, Maccabruni A, Salvini F, Cellini M, Ruggeri M, Manzionna M, Bernardi S, Tovo P, de Martino M; Italian Register for HIV Infection in Children: De Benedictis F, Osimani P, La Rovere D, Quercia M, Ruggeri M, Baldi F, Ciccia M, Faldella A, Masi M, Plebani A, Spinelli E, Dedoni M, Gariel D, Chiarello P, Magnolia MG, Sticca M, Vivalda L, Bezzi T, Fiumana E, Bianchi L, Battiglia N, Gervaso P, Bondi E, Cosso D, Gotta C, Ginocchio L, Rosso R, Viscoli C, Amoretti C, Esposito S, Farina F, Giacomet V, Lipreri R, Plebani A, Salvatici E, Stucchi S, Palazzi G, Paolucci P, De Luca G, Giannattasio A, Tancredi F, Tarallo L, Rampon O, Dalle Nogare E, Romano A, Saitta M, Mariani B, Biver P, Consolini R, Palla G, De Fanti A, Dodi I, Verna M, Bove G, Casadei AM, Castelli Gattinara G, Catania S, Martino AM, Sirufo MM, Ganau A, Cristiano L, Scolfaro C, Versace A, Portelli V, Gentilini L, Mazza A, Bernardon M, Bua J, Rabusin M, Pellegatta A, Fortunati P. Is the interruption of antiretroviral treatment during pregnancy an additional major risk factor for mother-to-child transmission of HIV type 1? Clin Infect Dis. 2009;1;48: 1310-7
20) Marchetti F, Bua J, Ronfani L, Tornese G, Piras G et al. From guidelines to clinical practice: management of undescended testis in Italy. The Italian collaborative study group on the undescended testis. (abstract) Acta Paediatrica 2009; 98, Issues 460: 95-6.
21) F Marchetti, J Bua, L Ronfani, G Tornese, G Piras, G Toffol, F Chiarelli, M Gangemi, J Schleef, G Tamburlini, A Ventura. Management of undescended testis in Italy: the use of hormonal therapy. The Italian collaborative study group on the undescended testis. (abstract) Hormone Research 2009; 72 (suppl 3), 448.
22) E Faleschini, J Bua, G Tonini. Treatment with the combination of GnRh analogue and rhGHin 3 patients with Turner mosaicism diagnosed after menarche. (abstract) Hormone Research 2009; 72 (suppl 3), 499-500.
23) J Bua, L Calligaris, I Berti, A Ventura, G Longo. The first case of oral tolerance induction in a 3-month old boy: the beginning of a revolution? (abstract) Pediatr Allergy Immunol 2009; Vol 20 (suppl 20), 47.
24) J Bua, F Marchetti, Faleschini E, Ventura A. Hepatic glycogenosis in an adolescent with diabetes. J Pediatr. 2010;157: 1042.
25) F Marchetti, J Bua, G Tornese, G Toffol, L Ronfani. Current management of cryptochidism: time for change. (e-letter) Pediatrics 2010 Oct 14. Rapid response to: Paul J. Kokorowski, Jonathan C. Routh, Dionne A. Graham, and Caleb P. Nelson. Variations in Timing of Surgery Among Boys Who Underwent Orchidopexy for Cryptorchidism.Pediatrics 2010; 126: e576-e582
26) Bua J, Trappan A, Demarini S, Grasso D, Schleef J, Zennaro F. Neonatal Necrotizing Tracheobronchitis. J Pediatr. 2011;159:699-699.
27) Bua J, Marchetti F, Zennaro F, Ventura A. A lung mass: when the history helps the diagnosis. BMJ Case Reports 2011; doi:10.1136/bcr.01.2011.3718.
28) Bua J, Travan L, Davanzo R, Demarini S. More on professionals' attitudes on blood-tinged milk: a survey from Italy. J Perinatol. 2012 Mar;32(3):243-4.
29) Marchetti F, Bua J, Tornese G, Piras G, Toffol G, Ronfani L; Italian Study Group on Undescended Testes. Management of cryptorchidism: a survey of clinical practice in Italy. BMC Pediatr. 2012 Jan 10;12:4
30) Davanzo R, Dal Bo S, Bua J, Copertino M, Zanelli E, Matarazzo L. Antiepileptic drugs and breastfeeding. Ital J Pediatr. 2013 Aug 28;39:50.
31) Paviotti G, De Cunto A, Travan L, Bua J, Cont G, Demarini S. Longitudinal Growth and Body Composition of Twins versus Singletons in the First Month of Life. ScientificWorldJournal. 2013 Dec 24;2013:108189.
32) De Cunto A, Paviotti G, Ronfani L, Travan L, Bua J, Cont G, Demarini S. Can body mass index accurately predict adiposity in newborns? Arch Dis Child Fetal Neonatal Ed. 2014 May;99(3):F238-9
33) Paviotti G, Bua J, De Cunto A, Travan L, Demarini S.High-frequency percussive ventilation as rescue treatment in severe hypoxemic respiratory failure in term neonates.J Crit Care. 2014 Aug;29(4):662-3.
34) Davanzo R, Bua J, Paloni G, Facchina G. Breastfeeding and migraine drugs. Eur J Clin Pharmacol. 2014 Nov;70(11):1313-24.
35) Bembich S, Travan L, Cont G, Bua J, Strajn T, Demarini S. Cerebral oxygenation with different nasal continuous positive airway pressure levels in preterm infants. Arch Dis Child Fetal Neonatal Ed. 2015;100(2):F165-8.
36) Bembich S, Cont G, Baldassi G, Bua J, Demarini S. Maternal holding vs oral glucose administration as nonpharmacologic analgesia in newborns: a functional neuroimaging study. JAMA Pediatr. 2015 Mar;169(3):284-5.
37) De Cunto A, Paviotti G, Travan L, Bua J, Cont G, Demarini S. Impact of Surgery for Neonatal Gastrointestinal Diseases on Weight and Fat Mass. J Pediatr. 2015 Sep;167(3):568-71
38) Davanzo R, Bua J, De Cunto A, Farina ML, De Ponti F, Clavenna A, Mandrella S, Sagone A, Clementi M. Advising Mothers on the Use of Medications during Breastfeeding: A Need for a Positive Attitude. J Hum Lact. 2016 Feb;32(1):15-9.
39) Bembich S, Cont G, Bua J, Orlando C, Di Benedetto D, Demarini S. Bolus feeding has no effect on cerebral hemodynamics, irrespective of gestational age. J Matern Fetal Neonatal Med. 2017 May;30(9):1029-1031.
40) Paviotti G, De Cunto A, Zennaro F, Boz G, Travan L, Cont G, Bua J, Demarini S. Higher growth, fat and fat-free masses correlate with larger cerebellar volumes in preterm infants at term. Acta Paediatr. 2017 Jun;106(6):918-925.
41) De Cunto A, Paviotti G, Bua J, Demarini S. Theophylline increases diaphragmatic contractility in mechanically ventilated newborns. J Crit Care. 2017 Feb;37:264-265.
42) Bua J, Massaro M, Cossovel F, Monasta L, Brovedani P, Cozzi G, Barbi E, Demarini S, Travan L. Intranasal dexmedetomidine, as midazolam-sparing drug, for MRI in preterm neonates. Paediatr Anaesth. 2018 Aug;28(8):747-748.
43) Berardi A, Tzialla C, Travan L, Bua J, Santori D, Azzalli M, Spada C, Lucaccioni L; GBS Prevention Working Group of Emilia-Romagna. Secondary prevention of early-onset sepsis: a less invasive Italian approach for managing neonates at risk. Ital J Pediatr. 2018 Jun 28;44(1):73.
44) Bembich S, Cont G, Bua J, Paviotti G, Demarini S. Cerebral Hemodynamics During Neonatal Cerebrospinal Fluid Removal. Pediatr Neurol. 2019 May;94:70-73.
45) Paviotti G, De Cunto A, Travan L, Bua J, Miron T, Cont G, Demarini S. Change in body composition of premature infants from parenteral nutrition discontinuation to term equivalent age. Early Hum Dev. 2020 Dec; 151:105163.
46) Berardi A, Cassetti T, Creti R, Vocale C, Ambretti S, Sarti M, Facchinetti F, Cose S; Prepare Network, Heath P, Le Doare K. The Italian arm of the PREPARE study: an international project to evaluate and license a maternal vaccine against group B streptococcus. Ital J Pediatr. 2020 Oct 28;46(1):160.
47) Milinco M, Travan L, Cattaneo A, Knowles A, Sola MV, Causin E, Cortivo C, Degrassi M, Di Tommaso F, Verardi G, Dipietro L, Piazza M, Scolz S, Rossetto M, Ronfani L; Trieste BN (Biological Nurturing) Investigators. Effectiveness of biological nurturing on early breastfeeding problems: a randomized controlled trial. Int Breastfeed J. 2020 Apr 5;15(1):21.
48) Battistuz E, Travan L, Bua J, Trappan A, Galdo F, Bobbo M, Barbi E, Risso FM. Newborn with hydrops fetalis and a severe supraventricular arrhythmia. Arch Dis Child Educ Pract Ed. 2021 Apr;106(2):103-104.
49) Pavan M, Pillon R, Bua J, Codrich D, Murru FM, Travan L, Risso FM. Milk curd problems in preterm infants are not just about obstructive symptoms. Acta Paediatr. 2021 Feb;110(2):487-488.
50) Ouedraogo P, Villani PE, Tubaldi L, Bua J, Uxa F, Dell'Anna C, Cavallin F, Thomson M, Plicco C, Chiesi MP. Impact of a quality improvement intervention on neonatal mortality in a regional hospital in Burkina Faso. J Matern Fetal Neonatal Med. 2021 Jan 5:1-6.
51) De Rose DU, Santisi A, Ronchetti MP, Martini L, Serafini L, Betta P, Maino M, Cavigioli F, Cocchi I, Pugni L, Bonanno E, Tzialla C, Giuffrè M, Bua J, Della Torre B, Nardella G, Mazzeo D, Manzoni P, Dotta A, Bagolan P, Auriti C, On Behalf Of Study Group Of Neonatal Infectious Diseases. Invasive Candida Infections in Neonates after Major Surgery: Current Evidence and New Directions. Pathogens. 2021 Mar 9;10(3):319.
52) Bua J, Risso FM, Bin M, Vallon F, Travan L, Paviotti G. Association between body composition at term equivalent age and Bayley scores at 2 years in preterm infants. J Perinatol. 2021 May 13. doi: 10.1038/s41372-021-01074-x.
53) Berardi A, Trevisani V, Di Caprio A, Bua J, China M, Perrone B, Pagano R, Lucaccioni L, Fanaro S, Iughetti L, Lugli L, Creti R. Understanding Factors in Group B Streptococcus Late-Onset Disease. Infect Drug Resist. 2021 Aug 17;14:3207-3218. doi: 10.2147/IDR.S291511.
54) Bua J, Mariani I, Girardelli M, Tomadin M, Tripani A, Travan L, Lazzerini M. Parental Stress, Depression, and Participation in Care Before and During the COVID-19 Pandemic: A Prospective Observational Study in an Italian Neonatal Intensive Care Unit. Front Pediatr. 2021 Sep 30;9:737089. doi: 10.3389/fped.2021.737089. PMID: 34660492; PMCID: PMC8515023
55) Servidio AG, Visentin G, Conti R, Cozzi G, Travan L, Bua J, Barbi E, Amaddeo A. Mild COVID-19 in hospitalised infants younger than 90 days. Acta Paediatr. 2023 Mar;112(3):483-485. doi: 10.1111/apa.16624. Epub 2022 Dec 21. PMID: 36513613; PMCID: PMC9878078
56) Pichler G, Goeral K, Hammerl M, Perme T, Dempsey EM, Springer L, Lista G, Szczapa T, Fuchs H, Karpinski L, Bua J, Avian A, Law B, Urlesberger B, Buchmayer J, Kiechl-Kohlendorfer U, Kornhauser-Cerar L, Schwarz CE, Gründler K, Stucchi I, Schwaberger B, Klebermass-Schrehof K, Schmölzer GM; COSGOD III study group. Cerebral regional tissue Oxygen Saturation to Guide Oxygen Delivery in preterm neonates during immediate transition after birth (COSGOD III): multicentre randomised phase 3 clinical trial. BMJ. 2023 Jan 24;380:e072313. doi: 10.1136/bmj-2022-072313. PMID: 36693654; PMCID: PMC9871806.
57) Starc M, Giangreco M, Centomo G, Travan L, Bua J. Extrauterine growth restriction in very low birth weight infants according to different growth charts: A retrospective 10 years observational study. PLoS One. 2023 Apr 20;18(4):e0283367. doi: 10.1371/journal.pone.0283367. PMID: 37079523; PMCID: PMC10118091.
58) Berardi A, Trevisani V, Di Caprio A, Caccamo P, Latorre G, Loprieno S, Foglianese A, Laforgia N, Perrone B, Nicolini G, Ciccia M, Capretti MG, Giugno C, Rizzo V, Merazzi D, Fanaro S, Taurino L, Pulvirenti RM, Orlandini S, Auriti C, Haass C, Ligi L, Vellani G, Tzialla C, Tuoni C, Santori D, Baroni L, China M, Bua J, Visintini F, Decembrino L, Creti R, Miselli F, Bedetti L, Lugli L. Timing of Symptoms of Early-Onset Sepsis after Intrapartum Antibiotic Prophylaxis: Can It Inform the Neonatal Management? Pathogens. 2023 Apr 13;12(4):588. doi: 10.3390/pathogens12040588. PMID: 37111474; PMCID: PMC10140896.
59) De Rose DU, Santisi A, Ronchetti MP, Martini L, Serafini L, Betta P, Maino M, Cavigioli F, Giuffré M, Bonanno E, Tzialla C, Bua J, Pugni L, Della Torre B, Nardella G, Mazzeo D, Ravà L, Bagolan P, Dotta A, Auriti C; Study Group of Neonatal Infectious Diseases of The Italian Society of Neonatology (SIN). Decreased incidence of late-onset sepsis during the SARS-CoV-2 pandemic in Italy: a multicentric study on a cohort of infants requiring major surgery. Eur J Pediatr. 2023 Aug 16. doi: 10.1007/s00431-023-05144-4. Epub ahead of print. PMID: 37582826.
Last updated on: 04/25/2024 - 01:10
